Senator Jeanne Shaheen has long fought for the rights of Granite Staters to have access to affordable, comprehensive, high-quality health care. Her past support of efforts to end surprise medical billing for patients proves it.
The dark money attack campaign against her is trying to fool voters in an election year, and play politics with the lives of Granite Staters. This is an issue that has unfairly hurt far too many patients in New Hampshire and across the country. Given her track record of supporting patient protections, Senator Shaheen has shown she is an important ally in ending the unfair practice of surprise billing nationwide. She deserves our gratitude and support.
Congress seems poised to finally address this issue once and for all; however, there are currently differing approaches that have been introduced in various pieces of legislation. Some of these proposed solutions work well—essentially ending surprise billing and maintaining access and affordability for all patients—while others would solve the one problem while introducing a whole host of new problems that hurt vulnerable patients.
For example, a proposal known as benchmarking would establish unfairly and artificially low rates for physicians providing out-of-network care. By tying rates to in-network averages, which undergo deep discounts during contract negotiations, benchmarking would slash reimbursements for physicians, creating huge financial losses for hospitals and emergency rooms.
Many of these health care facilities are already struggling financially, particularly the at-risk emergency rooms that serve greater numbers of uninsured, underinsured, Medicare, or Medicaid patients. That is why emergency room physicians rely on fair reimbursements from the smaller share of patients that are insured. Cutting these payments so drastically could contribute to our nation’s doctor shortage as well as higher provider consolidation rates, either of which would be disastrous for patient access, choice, and affordability.
A true solution for surprise medical billing should not undermine care for anyone, least of all the patients who already struggle to afford the treatments and services they need to live healthier lives. That is why I am hopeful Congress will pass—and Senator Shaheen will help support—surprise billing legislation that uses Independent Dispute Resolution (IDR) as the mechanism for protecting patients from surprise billing instead of the misguided, dangerously short-sighted benchmarking approach.
IDR is essentially a process that allows health care insurers and medical providers to negotiate individual out-of-network payments in the event of a dispute. Both parties would be empowered to provide their most reasonable offers for payments through an easy, online process. Within 30 days, a neutral, third-party mediator would determine a final payment amount based on these offers and a number of other factors that include verifiable, independent data. Furthermore, initial payments to providers would help keep at-risk hospitals and emergency rooms open and operational.
Through this approach, patients will be protected from surprise billing while providers will be able to continue offering quality care and services without negatively impacting the patient experience for anyone. If lawmakers in Washington need any proof of IDR’s efficacy in that regard, they only need to look at New York to see how well it works.
Since the implementation of a state law that includes the process in 2015, New Yorkers have been protected from surprise billing while reaping the many benefits of IDR. These include a 34 percent reduction in out-of-network billing, a 9 percent reduction in emergency costs, and a $400 million savings in emergency services for New Yorkers. The law has also provided new incentives for insurers to enter into fair contract negotiations with doctors, helping grow provider networks, which only further improves access and lowers costs for patients.
Senator Shaheen has always done what’s right for New Hampshire—and I know she will do the right thing again by supporting a strong, IDR-based solution just as Senator Hassan has done. We are fortunate to have leaders like these two senators—as well as Representatives Kuster and Pappas—looking out for the health care needs of Granite Staters. I know they won’t let us down when it comes to solving surprise billing the right way.